Clinical Report: Development and validation of a 28-day mortality risk assessment model

Overview

This study establishes a 28-day mortality prediction model for septic shock patients with left ventricular systolic dysfunction (LVSD). The model demonstrates excellent discriminative power and is validated internally and externally.

Background

Septic shock is a leading cause of mortality in intensive care units, with a high incidence of left ventricular systolic dysfunction (LVSD) among affected patients. Traditional prognostic models often lack specificity.

Data Highlights

Key Findings

• The model identified independent predictors of 28-day mortality: LVSD, decreased pH, atrial arrhythmia, dopamine use, and reduced PaO2/FiO2.
• The area under the ROC curve (AUC) for the training cohort was 0.767.
• Internal validation yielded a mean AUC of 0.779.
• The model showed superior predictive performance compared to the APACHE II score (0.767 vs. 0.652, P = 0.006).
• A web-based dynamic nomogram calculator has been developed for public use.

Clinical Implications

The developed model provides a robust tool for clinicians to assess mortality risk in septic shock patients with LVSD. Its superior performance compared to existing models may facilitate earlier interventions and improved patient management.

Conclusion

The 28-day mortality prediction model offers a tool for risk stratification for septic shock patients with LVSD.

Related Resources & Content

1. Frontiers in Medicine, 2026 -- Development and external validation of a parsimonious lactate-to-diastolic blood pressure ratio model for 28-day mortality risk stratification in septic shock
2. Intensive Care Medicine, 2015 -- A predictive model for assessing mortality risk among emergency department patients
3. Frontiers in Medicine, 2026 -- Hematologic and metabolic indices for predicting 28-day mortality in sepsis patients
4. Clinical Research in Cardiology, 2025 -- Assessing Risk in Heart Failure Through Invasive Hemodynamic Measurements
5. Surviving Sepsis Campaign Adult Guidelines | SCCM, 2026 -- Guidelines and resources
6. JAMA, 2025 -- Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial
7. CoLab -- Time Course of Morbidity and Mortality Across Echocardiographic Phenotypes in Patients With Sepsis: A Systematic Review and Meta-Analysis
8. Surviving Sepsis Campaign Adult Guidelines | SCCM
9. Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial | Acid Base, Electrolytes, Fluids | JAMA | JAMA Network
10. Time Course of Morbidity and Mortality Across Echocardiographic Phenotypes in Patients With Sepsis: A Systematic Review and Meta-Analysis | CoLab